| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TRIBRIDGE PARTNERS LLC3 | 6721 COLUMBIA GATEWAY DRIVE SUITE 100 COLUMBIA, MD 21046 | PRINCIPAL LIFE INSURANCE COMPANY | $7K | $244 | $8K | 9.48% |
| EBSME LLC3 | PO BOX 120 MOUNT AIRY, MD 217710120 | PRINCIPAL LIFE INSURANCE COMPANY | $772 | $0 | $772 | 0.95% |
| ARMFIELD HARRISON & THOMAS3 Filed as: ARMFIELD HARRISON & THOMAS LLC | 20 S KING ST LEESBURG, VA 20175 | PRINCIPAL LIFE INSURANCE COMPANY | $725 | $0 | $725 | 0.89% |
| TRIBRIDGE PARTNERS LLC3 | 6721 COLUMBIA GATEWAY DRIVE SUITE 100 COLUMBIA, MD 21046 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $827 | $3K | 18.11% |
| EBSME LLC3 | 4704 DE INVIERNO WAY MOUNT AIRY, MD 21771 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $98 | $58 | $156 | 0.87% |
| ARMFIELD HARRISON & THOMAS3 Filed as: ARMFIELD, HARRISON & THOMAS LLC | 20 S KING ST LEESBURG, VA 20175 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $29 | $0 | $29 | 0.16% |
| TRIBRIDGE PARTNERS LLC3 | 6721 COLUMBIA GATEWAY DRIVE SUITE 100 COLUMBIA, MD 21046 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $736 | $2K | 14.14% |
| EBSME LLC3 | 4704 DE INVIERNO WAY MOUNT AIRY, MD 21771 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $60 | $52 | $112 | 0.71% |
| ARMFIELD HARRISON & THOMAS3 Filed as: ARMFIELD HARRISON & THOMAS LLC | 20 S KING ST LEESBURG, VA 20175 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $19 | $0 | $19 | 0.12% |
| TRIBRIDGE PARTNERS LLC3 | 6721 COLUMBIA GATEWAY DRIVE SUITE 100 COLUMBIA, MD 21046 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $638 | $3K | 18.80% |
| EBSME LLC3 | 4704 DE INVIERNO WAY MOUNT AIRY, MD 21771 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $79 | $45 | $124 | 0.88% |
| ARMFIELD HARRISON & THOMAS3 Filed as: ARMFIELD, HARRISON & THOMAS LLC | 20 S KING ST SUITE 902 LEESBURG, VA 20175 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $26 | $0 | $26 | 0.19% |
| TRIBRIDGE PARTNERS LLC3 | 6721 COLUMBIA GATEWAY DRIVE SUITE 100 COLUMBIA, MD 21046 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $521 | $2K | 14.05% |
| EBSNE LLC3 | 4704 DE INVIERNO WAY MOUNT AIRY, MD 217715030 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $43 | $37 | $80 | 0.70% |
| ARMFIELD HARRISON & THOMAS3 Filed as: ARMFIELD, HARRISON & THOMAS LLC | 20 S KING ST LEESBURG, VA 20175 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $14 | $0 | $14 | 0.12% |
| TRIBRIDGE PARTNERS LLC3 | 6721 COLUMBIA GATEWAY DR STE 100 COLUMBIA, MD 21046 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $948 | $146 | $1K | 17.31% |
| EBSME LLC3 | 4704 DE INVIERNO WAY MOUNT AIRY, MD 217715030 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $144 | $144 | 2.28% |
| ARMFIELD HARRISON & THOMAS3 Filed as: ARMFIELD HARRISON & THOMAS LLC | 20 S KING ST LEESBURG, VA 20175 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $77 | $77 | 1.22% |
| TRIBRIDGE PARTNERS LLC3 | 6721 COLUMBIA GATEWAY DR STE 100 COLUMBIA, MD 21046 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $295 | $110 | $405 | 9.60% |
| EBSME LLC3 | 4704 DE INVIERNO WAY MOUNT AIRY, MD 217715030 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $93 | $93 | 2.21% |
| ARMFIELD HARRISON & THOMAS3 Filed as: ARMFIELD HARRISON & THOMAS LLC | 20 S KING ST LEESBURG, VA 20175 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $34 | $34 | 0.81% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAREFIRST ADMIN | Claims processing Service code 12 | 1501 S. CLINTON ST 7TH FLOOR BALTIMORE, MD 21224 | $39K |
| TRIBRIDGE PARTNERS BROKER | Insurance agents and brokers Service code 22 | 1 E PRATT ST SUITE 902 BALTIMORE, MD 21202 | $23K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $15K |
| CONNECTCARE 3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $4K |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 94 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 96 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 184 | $82K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 184 | $82K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 94 | $16K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 94 | $18K |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 68 | $333K |
| Other(5 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 94 | $52K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 184 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
No prospect flags tripped on this filing.